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Table 1 The examination methods used by podiatrists in current practice (identified from Phase 1,2 and 3)

From: Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle

Biomechanical examination Method
Neutral calcaneal stance position (NCSP) and relaxed calcaneal stance position (RCSP) (i) Participant standing (ii) Position both feet into NCSP (iii) Pen marker bisection line drawn onto the posterior aspect of the calcaneus on both feet (iv) Measurement recorded using digital biometer for right foot (v) Identify if calcaneus is positioned varus or valgus (vi) Repeat procedure with left foot (vii)Both feet resume RCSP, measurement of the bisection line using a digital biometer for both feet
Range of ankle joint dorsiflexion (i) Participant supine and sitting with back straight against plinth (ii) A straight reference line is drawn onto the lateral aspect of leg indicating where one of the tractograph arms should be positioned (iii) Tractograph is positioned with one lever arm running parallel to the lateral aspect of leg and the other positioned parallel to the plantar aspect of the foot running distally (iii) With the knee joint extended, the foot is maximally dorsiflexed and the measurement on the tractograph recorded (iv) The knee joint is held in a flexed position, the ankle joint is maximally dorsiflexed and the measurement on the tractograph recorded (v) Repeat procedure with other foot
Position and mobility at the first ray (i) Participant supine and sitting with back straight against plinth (ii) First ray position classification (dorsiflexed/plantarflexed or neutral) (iii) First ray mobility classification (flexible/rigid/normal) (iv) Repeat procedure with cother foot
Forefoot to rearfoot relationship (frontal plane) (i) Participant prone, lying down (ii) Raise one side of pelvis from couch with a cushion/pillow, so that the long axis of the contra lateral foot is vertical (iii) Position the foot in subtalar joint neutral (iv) Visually observe position of forefoot relative to rearfoot. Categorise if neutral/everted/inverted.(v) Repeat procedure with other foot
Range of motion at the first MTPJ (i) Participant supine and sitting with back straight against plinth with legs extended in front (ii) Place arms of the goniometer parallel to the long axis of the first metatarsal and the proximal phalanx of the hallux (iii) Manually dorsiflex first MTPJ with first ray free to move and measure range of motion with goniometer (iv) Repeat stage 3, with first ray held in a neutral position (v) Repeat procedure with left foot
Foot Posture Index The 6 Point FPI is to be used and follows the protocol described by Redmond et al. [31]
Limb length examination (i) Participant standing in RCSP (ii) Both ASIS are palpated, identification of whether a limb length discrepancy is present (iii) Classification of which leg is longer and whether this is less than 5 mm, more than 5 mm or more than 10 mm
Visual gait analysis On conducting a clinical gait analysis, key determinants to be observed (i) Position of foot at heel strike (ii) Forefoot and midfoot position during loading phase. (iii) Foot position and motion during propulsion and re-supination (iv) Movement of the foot and leg during swing phase (v) Motion of the hip and knee (vi) Timing and magnitude of motion